[Recurrent ampulla cardiomyopathy showing prolonged sympathetic nerve function disorder: a case report]

Area of Science:

• Cardiology
• Nuclear Medicine
• Nephrology

Background:

• A 58-year-old woman with chronic renal failure on hemodialysis experienced recurrent ampulla cardiomyopathy.
• This recurrence was linked to a prolonged sympathetic nerve function disorder.

Observation:

• 123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy was used for periodic evaluation since the initial event at age 55.
• High MIBG washout rates (initial 58.3%, discharge 33.0%, 1-year follow-up 45.4%) were consistently observed.
• Recurrence at age 58 showed a high washout rate (48.6%), with persistent high rates (49.5% and 40.1%) at 2 and 9 months post-discharge despite wall motion improvement.

Findings:

• 123I-MIBG scintigraphy effectively assesses the progression of recurrent ampulla cardiomyopathy.
• The study objectively evaluates the severity and persistence of sympathetic nerve function disorders in this patient.
• Consistently high MIBG washout rates correlated with recurrent cardiac events and sympathetic dysfunction.

Implications:

• 123I-MIBG myocardial scintigraphy is a valuable tool for monitoring ampulla cardiomyopathy and associated sympathetic nerve dysfunction.
• Sympathetic nerve dysfunction appears to be a critical factor in the pathophysiology of recurrent ampulla cardiomyopathy.
• This case highlights the importance of assessing cardiac sympathetic function in patients with chronic renal failure and cardiomyopathy.